Chapter 20: Pediatric Nursing Interventions & Clinical Skills

Pediatric Nursing Interventions & Clinical Skills begins by defining the legal and ethical requirements for informed consent, distinguishing between parental permission and the concept of assent for older children and adolescents, while noting exceptions for emergency situations. The text outlines developmentally appropriate strategies for preparing children for diagnostic and therapeutic procedures, utilizing child life specialists and therapeutic play to minimize psychological stress. Perioperative care is thoroughly detailed, including preoperative fasting guidelines to prevent aspiration, anxiety reduction techniques, and postoperative monitoring for complications such as malignant hyperthermia and respiratory compromise. The chapter covers fundamental hygiene practices, including skin care to prevent pressure injuries, and strategies for feeding sick children, while differentiating the management of fever versus hyperthermia. Safety protocols are extensively reviewed, focusing on fall prevention, environmental safety, and infection control through standard and transmission-based precautions. Specific guidelines are provided for the use of restraints and positioning for invasive procedures like lumbar punctures and bone marrow aspirations. A significant portion of the chapter is dedicated to specimen collection methods for urine, stool, blood, and respiratory secretions, alongside the safe administration of medications via oral, intramuscular (emphasizing sites like the vastus lateralis), intravenous, and alternative routes. It highlights the critical importance of accurate dosage calculations based on body weight or body surface area. Management of fluid balance is discussed, including the care of peripheral and central venous access devices, intraosseous infusion, and total parenteral nutrition. The text also explains enteral feeding techniques such as nasogastric gavage and gastrostomy care. Finally, the chapter addresses respiratory support measures, ranging from oxygen therapy and pulse oximetry monitoring to airway clearance techniques, tracheostomy care, and chest tube management.